Dr. Mody's primary research interest is epidemiology of nosocomial infections in long-term care and developing effective infection control strategies targeted at reducing these infections with a goal to reduce antimicrobial usage, antimicrobial resistance, and adverse events related to antibiotics. Nosocomial infections and adverse drug events particularly related to antibiotics are common preventable medical problems in nursing homes. Dr. Mody's goal is to develop infection control strategies that are targeted and practical while recognizing staffing, budget and care concerns of older adults in nursing homes. Indwelling devices, especially urinary catheters and feeding tubes, are commonly used and appear to play a key role in the development of urinary tract infections and aspiration pneumonias. Dr. Mody's immediate research goals during the Career Development Program are: 1. To assess the epidemiology of colonization with antibiotic-resistant pathogens associated with commonly used devices (urinary catheters, feeding tubes & intravenous lines) in nursing homes in Southeast Michigan. 2. Quantify infection risk and antimicrobial usage attributed to devices. 3. To assess knowledge, attitudes, opinions, and practices of nursing personnel to existing infection control guidelines to prevent device-related infections 4. Assess the efficacy of a targeted infection control program in reducing infections related to devices incorporating educational needs of healthcare workers in nursing homes. This Career Development Award will serve 3 goals: First, this grant will allow Dr. Mody to build on her previous projects conducted during residency and fellowship focusing on the epidemiology and prevention of infection in older adults. Second, it will provide her with an opportunity to take formal coursework in epidemiology and health services research, which will be instrumental to advancing her research career. Third, it will give me a chance to collaborate with a group of community nursing homes in Southeast Michigan. The primary goal of this collaboration will be to design and conduct further outcomes based research projects focusing on nosocomial infections as adverse events and leading to meaningful strategies to improve quality of care of older adults in institutional setting.